Allocations Application | Fund for the Arts

The Screening and Allocations Committee ("S&A Committee") of Fund for the Arts ("FFA") will process your funding request. Please contact the Chair of the S&A Committee or your Board liaison with any questions relating to this process. Executive Director Margaret Lieberman (artsfundwv@frontier.com or 304-345-0775) can provide names and contact information.

Arts groups must complete an Allocations Application each year by September 30. The S&A Committee Chair will send an email confirmation of receipt. FFA issues checks during the second week of January.

Organization's Name *
Person Completing Form *
First Last
Organization's Primary Contact *
First Last
Primary Contact's Title
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *

Confirm email (required)
Phone
### - ### - ####
Web Site
Current Officers
*

Name

President

Vice President

Secretary

Treasurer
Formalities, Filings, and Compliance
These questions relate to your most recently-completed full artistic season.

	Name
President
Vice President
Secretary
Treasurer

	Answer
When did the organization's officers last change?
How many times did the organization hold a formal board meeting?
Did the organization's board meet in person, by telephone, via internet, or some combination?
Did the organization keep minutes of each board meeting?
Did the organization prepare financial statements more often than annually? If so, who examined those statements?
Who prepared the organization's last tax return, and what was that person's position with the organization?
Who prepared the organization's last annual report with the secretary of state, and what was that person's position with the organization?
Is the organization up to date on its tax filings (e.g., payroll, unemployment compensation)?
Was the organization investigated by any local, state, or federal regulatory authority?

Organizational Changes
These questions again relate to your most recently-completed full artistic season.

	Answer
Did the organization sponsor the same number of events as in the prior season, more events, or fewer events? Why?
Did the organization have about the same amount of income as in the prior season, more income, or less income? Why?
Did the organization's cash position stay the same as it was the prior season or did its cash position improve or decline? Why?
Did the organization spend about the same amount of money as in the prior season, more money, or less money? Why?
Outside of productions, did the organization pay employees or engage independent contractors? If so, briefly describe all paid positions.
Did the organization's employee or independent contractor count change from the prior season? If so, how and why?
Did the organization's membership grow, shrink, or stay about the same as in the prior season? Describe any changes, and explain, if you can, why those changes occurred.
Does the organization plan to sponsor any events in the upcoming_current season that are out of the ordinary for the organization? If so, what are those events and why is the organization sponsoring them?
What assistance did the organization give to Fund for Arts over the year under review, e.g., volunteers supplied, tickets to fundraisers purchased or sold, etc.?

Financial Information
Attach your organization's most recently-filed Form 990 or Form 990EZ or an audited financial statement that is no more than twelve months old.

Alternatively, if your organization does not file a Form 990 or Form 990EZ, provide financial information below for your most recently-completed fiscal period and your budgeted and actual position for the current fiscal year.
Fiscal Year End
MM / DD / YYYY

Financial Position

	Last fiscal period	Current year to date
Cash
Net Receivables (with allowance for doubtful accounts)
Other Current Assets **
Investments
Other Non-Current Assets **
Fixed Assets, Net
Accounts Payable
Other Short-Term Liabilities
Long-term Liabilities
Equity \| Net Assets

** Other Item Descriptions
Please provide a brief description of other categories (i.e., other assets or liabilities)

Financial Results

	Last fiscal period	Budgeted for current fiscal year	Actual for current year to date
Donation & Fundraising
Ticket Sales
Cost of Productions
Salaries & Benefits
Utilities & Office Costs
Professional Fees (attorney, CPA, etc.)
Advertising \| Promotion Fees

Revenue from Solicitations of Businesses, Foundations, or Government Agencies

	Name	Source (Business, Foundation, or Govt Agency)	Cash Amount / Description of In-Kind Donation	Purpose of Solicitation (Event, Capital Campaign, or Endowment)	FFA Approval Date
Revenue Source #1
Revenue Source #2
Revenue Source #3
Revenue Source #4
Revenue Source #5

Revenue Sources (additional notes)
Use this area to disclose any additional revenue solicited from businesses, foundations, or government agencies. You must disclose at least 90% of all non-ticket revenue solicited from businesses, foundations, or government agencies.
Program Data, Last Completed Season
Summarize your past year of programming.

	Program #1	Program #2	Program #3	Program #4
Program Name
Program Description
How many community members were served (directly or indirectly) by this program?
What percentage of the talent was from outside West Virginia?
What was the price of admission?
Did you offer any subsidies or assistance for admission? (please explain)
How many paid employees/contractors did you use to produce this program?
How many volunteers did you use to produce this program?
What did you do to reach poorer communities or underserved populations?
Did you fill an important niche in the metro-area arts community? (please explain)
How do you measure the success or failure of new initiatives?

Additional Information (last completed season)
Program Data, Upcoming_Current Season
Summarize your upcoming_current year of programming.
Upcoming Programs

Program #1 Program #2 Program #3 Program #4

Program Name

Program Description

Program Date

Program Location
Additional Information (upcoming_current season)
Policy Acknowledgements
FFA's allocation of funding to your organization is based on (1) community support of your organization, (2) financial responsibility of your organization, (3) financial need of your organization, (4) minimum program standards, and (5) such other factors the S&A Committee may establish from time to time.

See Bylaws, Article IX, Sec 9.1
Please indicate acknowledgements of policies by checking respective boxes. *
Has the Beneficiary Agency reviewed FFA's Policy on Independent Fund-Raising from Businesses, Business Foundations, and Local Governments by Beneficiary Agencies ("Independent Fund-Raising Policy") and complied with its terms?
Has the Beneficiary Agency reviewed Fund for the Art's last-published annual list of donors, available at http://fundfortheartswv.org/sponsors ?
Has the Beneficiary Agency refrained altogether from soliciting from businesses, foundations, and government during the months of February, March, and April, the period during which FFA conducts its major, direct fundraising efforts?
Has the Beneficiary Agency refrained from soliciting support from FFA's donors except with prior approval by FFA, which may be given for special projects, capital improvements, or endowment funds?
With respect to funds solicited for special events or projects during the reporting year, did the Beneficiary Agency report to FFA information about the events or projects in its request to proceed?
With respect to funds solicited for capital improvements or endowment fund purposes during the reporting year, did the Beneficiary Agency provide to FFA dates and usage of requested funding?
Has the Beneficiary Agency reported to FFA in this application all contributions received during the reporting year from businesses, foundations, and government agencies?
Has the Beneficiary Agency reported to FFA in this application all in-kind contributions of materials, supplies, furniture, equipment, fixtures, or services it received during the reporting year?
Has the Beneficiary Agency displayed prominently on all printed materials the logo of Fund for the Arts?
Has the Beneficiary Agency included in each of its programs an advertisement acknowledging the gifts of contributors who donated more than $10,000 to FFA the year before the reporting year?
File Upload
Upload in pdf your organization's last-filed Form 990 or 990EZ or an audited financial statement that is not more than twelve months old.
Certification *
Please certify information provided above. (President or equivalent should certify.)

Current Officers

Formalities, Filings, and Compliance

Organizational Changes

Financial Information

Program Data, Last Completed Season

Program Data, Upcoming_Current Season

Policy Acknowledgements